TY - JOUR
T1 - Pay-for-performance and dental procedures
T2 - A longitudinal analysis of the Brazilian Program for the Improvement of Access and Quality of Dental Specialities Centres
AU - Cabreira, Fabiana da Silva
AU - Hugo, Fernando Neves
AU - Celeste, Roger Keller
N1 - Publisher Copyright:
© 2021 The Authors. Community Dentistry and Oral Epidemiology published by John Wiley & Sons Ltd.
PY - 2022/2
Y1 - 2022/2
N2 - Objective: Evaluate the impact of a pay-for-performance program on changes in the number of dental procedures performed by public secondary dental care services in Brazil. Methods: A longitudinal study was carried out with 932 public Dental Specialities Centres (Centro de Especialidades Odontológicas – CEO) that participated in the pay-for-performance Program for the Improvement of Access and Quality of Dental Specialities Centres Services (PMAQ/CEO) and 379 non-CEO centres with secondary dental production. The non-CEO and a group of CEOs did not receive financial incentives from the PMAQ-CEO and served as control groups. Three CEOs groups received additional financial incentives of 20%, 60% or 100% over maintenance values, based on their performance scores. The outcome was the increase (yes/no) in the number of dental procedures between 2011/2013 and 2015/2017. Analyses were carried out using logistic regressions. Results: The number of specialized procedures increased in 48.4% of the services, 44.6% among non-CEO, 52.3% among CEO with no financial incentive and 59.1% among CEO with 100% incentive. The fully adjusted model showed that CEOs receiving 100% of the financial incentive had greater odds of increasing the production of dental procedures (OR = 1.65, 95%CI: 1.09–2.51). Services that increased the number of specialist dentists had (OR = 2.35, 95%CI 1.88–2.94). Municipalities that increased in coverage of private dental insurance had OR = 0.98 (95%CI: 0.94–1.02), and those with higher coverage of primary dental care had OR = 1.02 (95%CI: 0.99–1.05). Conclusion: Pay-for-performance may increase the production of dental procedures by CEOs, and mechanisms explaining it must be further investigated.
AB - Objective: Evaluate the impact of a pay-for-performance program on changes in the number of dental procedures performed by public secondary dental care services in Brazil. Methods: A longitudinal study was carried out with 932 public Dental Specialities Centres (Centro de Especialidades Odontológicas – CEO) that participated in the pay-for-performance Program for the Improvement of Access and Quality of Dental Specialities Centres Services (PMAQ/CEO) and 379 non-CEO centres with secondary dental production. The non-CEO and a group of CEOs did not receive financial incentives from the PMAQ-CEO and served as control groups. Three CEOs groups received additional financial incentives of 20%, 60% or 100% over maintenance values, based on their performance scores. The outcome was the increase (yes/no) in the number of dental procedures between 2011/2013 and 2015/2017. Analyses were carried out using logistic regressions. Results: The number of specialized procedures increased in 48.4% of the services, 44.6% among non-CEO, 52.3% among CEO with no financial incentive and 59.1% among CEO with 100% incentive. The fully adjusted model showed that CEOs receiving 100% of the financial incentive had greater odds of increasing the production of dental procedures (OR = 1.65, 95%CI: 1.09–2.51). Services that increased the number of specialist dentists had (OR = 2.35, 95%CI 1.88–2.94). Municipalities that increased in coverage of private dental insurance had OR = 0.98 (95%CI: 0.94–1.02), and those with higher coverage of primary dental care had OR = 1.02 (95%CI: 0.99–1.05). Conclusion: Pay-for-performance may increase the production of dental procedures by CEOs, and mechanisms explaining it must be further investigated.
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U2 - 10.1111/cdoe.12717
DO - 10.1111/cdoe.12717
M3 - Article
C2 - 34967967
AN - SCOPUS:85122147153
SN - 0301-5661
VL - 50
SP - 4
EP - 10
JO - Community Dentistry and Oral Epidemiology
JF - Community Dentistry and Oral Epidemiology
IS - 1
ER -